HomeMy WebLinkAboutPermit Plumbing 2013-8-29 •
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SPRINGFIELD-- 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-01954
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 08/29/2013 EXPIRES: 02/24/2014
STATUS DATE: 08/29/2013 APPLIED: 08/29/2013
SITE ADDRESS: 205 22ND ST,Springfield,OR 97477 SCOPE: Plumbing Only
ASSESOR'S PARCEL NO: 1703361302500 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Relocate laundry and convert to full bath
OWNER: NILES ALISCIA M&TAYLOR JASON P Phone Number:
ADDRESS: 205 22ND ST
SPRINGFIELD OR 97477
• L_ CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
General Contractor BRIAN MURRY CONSTRUCTION LLC COB 137757 09/08/2015 541-686-9929
Plumbing Contractor DON LEWIS PLUMBING SERVICE LLC COB 167921 01/06/2014 541-688-1931
INSPECTIONS REQUIRED
Inspections
3170 Underfloor Plumbing Underfloor Plumbing: Prior to insulation or decking.
3500 Rough Plumbing Rough Plumbing: Prior to cover and including required testing.
3999 Final Plumbing Final Plumbing: When all plumbing work is complete.
By signature, I state and agree,that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the
Ordinances of the City of Springfield and the Laws of the State or Oregon pertaining to the work described herein, and that NO
OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further
certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree
to ensure that all required inspections are requested at the proper time,that each address is readable from the street, that the
permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during
construction.
jQner or Contractor Signature - Date
ATTENTION: Oregon law requires
follow rules adgoted by the Or
Notification Cent Y°u to
in OAR 952-001-0010.r Those rules aye set forth
0090. You through OAR 952-001-
�TiGE: °altng the center. (Note the telephone the rules by
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US PERMIT SHALL EXPIRE IF THEWORK numberCe°ntehe Oregon y Noltiti at,on
gon utilit
UTHORIZED UNDER THIS PERMIT IS NOT 500-332-2344)•
LOMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
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Springfield Building Permit 8/29/2013 10:01:18AM Page 1 of 1
SPRINGFIELD— CITY OF SPRINGFIELD
225 Fifth St
TRANSACTION RECEIPT Spdngfield,OR 97477
,' 541-726-3753
OREGON 811-SPR2013-01954
wwwspringfield-or.gov 205 22ND ST permitcenter @springfietd-cr.gov
RECEIPT NO: 2013001918 - RECORD NO:811-SPR2013-01954 DATE:08/29/2013
t,M.
DESCRIPTION - '� ' ��
�....=tea ..ea��'`��_.. �u�,_,�_ .-Lk:ACCOUNTCODElFRANS CODE z:'b4r AMOUNT :: t
Fixture 224-00000-425603 1005 21.00
SDC: Improvement Cost- Local Wastewater 443-00000-448025 1184 487.48
SDC: Reimbursement Cost- Local Wastewater - 442-00000-448024 1183 • 998.76
SDC:Total Sewer Administration Fee 719-00000-426604 1175 74.31
Shower/Shower pan 224-00000-425603 1005 21.00
Sink/basin/lavatory 224-00000-425603 1005 21.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 10.08
Technology fee(5%of permit total) 100-00000-425605 2099 4.20
Water closet 224-00000-425603 1005 21.00
TOTAL DUE: 1,658.83
PAYMENTsTIVREMP,AYORR SNIERoKWIL50N COMMENTS-. - AMQUNTiOlI ,-
Credit Card Brian Murray Plumbing permit 1,658.83
08441G
TOTAL PAID: 1,658.83
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Plumbing Permit Application DEPARTMENT USE ONLY i
SPRINGFIELD 1
CITY OF SPRINGFIELD, OREGON Permit no.: .1 5 r (eiN`( i
[\t p/
225 Fifth Street Springfield,OR 97477 PH(541)726-3753 •FAX(541)726-3689 108EGOR Date: 2r. 3 {g
b
This permit is issued under OAR 918-780-0060.Permits are issued only to the person or contractor doing the work.Permits
expire if work is not started within 180 days of issuance or if work is suspended for 180 days.
LOCAL GOVERNMENT APPROVAL FEE SCHEDULE 1 I
Zoning approval verified? 0 Yes ❑No Description Q1Y• east cost 4 I
Sanitation approval verified? ❑ Yes ❑No New residential
CATEGORY OF CONSTRUCTION I bathroom/I kitchen(includes:first
Residential 0 Government 0 Commercial li JOfeetmaker.r/seinerlines.hose $262.00 $
bibs. ice nuke,. underfloor•Imr-point
JOB SITE INFORMATION AND LOCATION drains and rain-drain packages)
Job site address: 2.0 5 7Z,.v a. 2 bathrooms/I kitchen $411.00 $
City:5plj 1a if \ �. State: O 2 ZIP: 3 bathrooms/I kitchen $483.00 $
!! 1 Each additional bathroom(over 3) $104.50 $
Reference: Taxlot.: Each additional kitchen(over I) $104.50 $
DESCRIPTION OF WORK Residential fire sprinklers(includes plan review)
.s')evvx -- I Gin(A )AD F,.t I) ZZ�,gj,4-., 0 to 2,000 square feet $80.00 $
f'flo 4 \c' - gor•A frog— 2,001 to 3,600 square feet $128.00 $
P 1'r OPERTY OWNER 3,601 to 7,200 square feet $192.00 $
Name: s d.--� \Cvy/O.r 7,201 square feet and greater $255.00 $
! Manufactured dwelling or pre-fab(circle one)
Address:2 05 Z2- c_ Connections to building sewer and
water supply. $80.00 $
City: Rv (-\e.. State: 0? ZIP:
S Commercial,industrial,and dwellings other than one-or
Phone:S /-7J/- 1750 Fax: - - two-family I
E-mail: Minimum fee $80.00 $
This installation is being made on residential or farm property Each fixture $21.00 $ ry
owned by me or a member of my immediate family,and is Miscellaneous fees
exempt from licensing requirements under OAR 918-695-0020. 100' storm,sewer,water line $83.50 $
Signature: Each fixture,appurtenance,and piping $21.00 $
CONTRACTOR INSTALLATION Storm water retention/detention facility $21.00 $
Business name: S(-1 u", \,\AOY I rnQ f Irrigation systems $21.00 $
Piping or private storm drainage $21.00 $
Address:Fa 1�0)e . '/33 0 systems exceeding the first 100 feet
City: cte/V. State: O 1- ZIP:c /'OC Specialty fixtures $21.00 $
Reinspection(no.of hrs.x fee per hr.) $80.00 $
Phone:PIA 7/$- 116 1 Fax: - - Special requested inspections(no.of
`�/� $80.00 $
E-mail:bf‘av bf .ant^^v✓n/InoM(5•cep
r.-v hrs,x fee per hr.)
CCB license no.:1377c 1 BCD license no.: Each additional inspection:(I) $80.00 $
Plumbing license no.: Medical gas piping Minimum fee $
Print name: l (v.r V'\kV w Enter value of installation and equipment$_.
Enter fee based on installation and equipment value. $
Signature: APPLICANT USE
(A) Enter subtotal of above fees $
(Minimum Permit Fee$80.00) - �(...---
(B)Investigative fee(equal to[A]) $
(C)Enter 12%surcharge(.12 x[A+B]) $ (i7 -
(D)Technology Fee(5%of[A]) $
TOTAL fees and surcharges(A through D): $ i I
440-2500-1(4/1/2013/COM)